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The Cost of Heart Transplant in Iran: A Multicenter Analysis



Ahmadi ZH1 ; Shafaghi S1 ; Mandegar MH2 ; Salehi M3 ; Kashani BS4 ; Naghashzadeh F1 ; Jahangirifard A5 ; Bakhshandeh A3 ; Afshar A1 ; Kazempour M6 ; Sheikhan F7
Authors
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Authors Affiliations
  1. 1. Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Department of Cardiac Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Cardiovascular Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Tobacco Prevention and Control Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. Tracheal Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. Mycobacteriology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  7. 7. Research Center of Chronic Respiratory Diseases, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: International Journal of Organ Transplantation Medicine Published:2021

Abstract

Background: Heart transplantation is an established treatment for end-stage heart failure patients, but its cost-effectiveness is under question. Objective: This study aimed to assess the cost of heart transplantation in Iran as a developing country in Asia to contribute to future planning in the region. Methods: This study was conducted in two phases. First, in a retrospective multicenter study, hospital data of heart transplant and hospitalization of three active heart transplant centers in Tehran, Iran, were reviewed from April 2013 to May 2015. Then pre-transplantation, transplantation, and one-year posttransplant costs were calculated according to the ABC (activity-based costing) method in 2016. Results: Data were obtained for 120 patients, among which 95 (79.17%) were males with a mean (SD) age of 35.31±13.41 years. Mean (SD) hospital and ICU length of stay were 17.85±14.91 and 9.74±8.94 days, respectively. A significant correlation existed between the mean of hospital and ICU length of stay (P<0.001, r: 0.754). The mean heart transplant and hospitalization cost was 3445.47±1243.29 USD from 2013 to 2015. Using the activity-based costing method, the cost of pre-transplantation, transplantation, and one-year -post-transplantation were extracted 6.5%, 73.5%, and 20%, respectively, with a total cost of 26232 USD. Conclusion: Compared to other countries, the cost of heart transplantation in Iran is very low. Numerous reasons lead to this difference. Firstly, a heart transplantation surgery is performed in university-based hospitals and is supported by the government. On the other hand, a significant difference exists between personnel costs in Iran compared to other countries. © 2021. All Rights Reserved.
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